Mountaineer Behavioral Health
Mountaineer Behavioral Health was paid $309K by Medicaid between Jan 2018 and Aug 2020, across 6 billing codes. Its largest line is H2036, Alcohol and/or other drug treatment program, per diem — 53% of everything it billed.
MARTINSBURG, WV 25404
Next to other Specialist providers in West Virginia
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,821 | $115K | |
| 2020 | 1,278 | $194K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2036 | Alcohol and/or other drug treatment program, per diem | 53% | 773 | 61 | $165K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 34% | 1,710 | 312 | $105K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 9.8% | 295 | 136 | $30K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 1.5% | 227 | 56 | $5K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.2% | 77 | 40 | $4K |
| T1017 | Case management, billed per 15 minutesTargeted case management, each 15 minutes | <1% | 17 | 13 | $287.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Pyramid Health Care INC. | Wilkinsburg, PA | $128.75M |
| Pyramid Healthcare | Belleville, PA | $87.33M |
| Pyramid Healthcare, INC. | Newport News, VA | $40.65M |
| Pyramid Walden LLC | Charlotte Hall, MD | $27.53M |
| October Road INC. | Asheville, NC | $24.64M |
| Pyramid Health Care INC. | Duncansville, PA | $23.92M |
| Mountaineer Behavioral Health | Kearneysville, WV | $20.46M |
| Pyramid Walden, LLC | Joppa, MD | $16.70M |
| Pyramid Healthcare INC. | Altoona, PA | $14.30M |
| Pyramid Healthcare INC. | Altoona, PA | $13.25M |
| Pyramid Healthcare INC. | Allentown, PA | $11.01M |
| October Road, INC. | Mars Hill, NC | $10.82M |
| Pyramid Healthcare INC. | East Stroudsburg, PA | $10.38M |
| Pyramid Healthcare INC. | Langhorne, PA | $8.62M |
| Pyrmaid Healthcare INC. | York, PA | $8.19M |
| Pyramid Healthcare INC | Gibsonia, PA | $8.17M |
| Pyramid Healthcare, INC. | Radford, VA | $7.68M |
| Pyramid Walden, LLC | California, MD | $4.79M |
| Pyramid Healthcare INC. | Quakertown, PA | $4.16M |
| October Road, INC. | Asheville, NC | $3.63M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.